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Copyright TruRisk, LLC 20061 Overview Presentation Strategy—Winning by Changing the Rules (patents pending) TruRisk, LLC
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Copyright TruRisk, LLC 20062 Strategy—Winning by Changing the Rules Using better information (all medical claims) Forecasting claim cost more accurately utilizing proprietary Clinical/Statistical Models Modifying the distribution system—review all groups in medical plan or TPA then quote on groups with the greatest profit potential Change product attributes Patent innovations—IP is key asset
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Copyright TruRisk, LLC 20063 More Accurate Risk Assessment— All Lines, All Groups CUSTOMIZED CLINICAL STRUCTURE RAW DATA INTEGRATED PERSON AND GROUP DATA CLINICAL/ STATISTICAL ANALYTICS LTD LIFE CAPCOST™ and FIRST DOLLAR SPEC & AGG STD DECISION SUPPORT: STOP LOSS Data and Process Steps Underwriting Products
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Copyright TruRisk, LLC 20064 Paradigm Shift Evaluate risk and target favorable groups using Clinical/Statistical Models –Provide more accurate pricing of Disability and Life for medical customers –Lower loss ratio and its variability –Cross-sell with first dollar or medical stop loss coverage Lower future risks—target high risk Disability and Life employees for absence management
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Copyright TruRisk, LLC 20065 Evaluating Disability and Life Risk Medical claims and eligibility data required for cases to be underwritten Medical and Disability or Life claims do not need to be linked at the person or group level for model development Different Clinical/Statistical Models required for different insurance products Compare clinical risk to demographic and experience—calculate clinical/demographic ratio
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Copyright TruRisk, LLC 20066 Clinical/Statistical Models Benefits of medical underwriting without the cost or intrusion—based on group’s encrypted medical claims, eligibility data and Rx (when required) Far greater range in the person-level estimate of incidence rates Direct estimate of future risk—forward looking
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Copyright TruRisk, LLC 20067 What Will This Do for Me? Decrease loss ratios by using medical data to avoid groups with higher risk than indicated by demographics alone Increase close ratios on lower risk groups Increase market share by cross-selling Life and Disability to low risk groups with medical coverage—one stop shopping and medical management
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Copyright TruRisk, LLC 20068 Potential Profit Impact LTD Based on one client’s data for cases under 1,000 lives –Avoiding the worst 5% of cases would result in increasing margins from 14% to 36% –Assume avoid ½ of bad groups, margin becomes 25% or 11% increase Additional profit produced by targeting low clinical risk groups –21% groups have clinical/demo ratio<.80 –10% premium reduction gives clinical loss ratio=(.8/.9)*(current loss ratio)=.89 or lower of current Retrospective analysis of groups with High Clinical/Demo Ratios had 55% greater Experience/Manual Ratio than Low Clinical/Demo Ratio groups, results from modest size validation study 10% reduction in loss ratio is target for LTD and Life
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Copyright TruRisk, LLC 20069 Underwriting Summary Report
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Copyright TruRisk, LLC 200610 Example Clinical Profile for Underwriting and Medical Management—Summary
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Copyright TruRisk, LLC 200611 Implementing the Strategy Short term –Implement clinical/statistical underwriting and quantify loss ratio decrease for Life and Disability Longer term –Optimize marketing and underwriting tactics –Streamline and automate small/medium group underwriting processes
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Copyright TruRisk, LLC 200612 Require more information? Contact: greg.binns@TruRisk.com 847.295.2891
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